目的：通过分析本院34例确诊为泪小管炎的患者，探究泪小管炎致病因及其临床特征，并研究常见误诊情况以提高确诊率，为医务工作者提供临床经验。

方法：选取2011-06/2015-06来我院进行泪小管切开术的患者临床病例共34例34眼，统计患者的临床资料，包括年龄与性别分布、眼别与病变位置、病程、泪小管炎的临床症状及既往误诊情况。实行泪小管切开术，对泪小管分泌物行微生物培养检查。

结果：所选患者40岁以上人群占77%，男性占23.5%，女性占76.5%。左眼15例，右眼19例，且均为单眼发病，下泪小管炎患者26例(76%)。患者临床症状：分泌物增多、内眦部结膜充血、泪小管四周红肿、病变位置轻微触痛感、泪小点红肿凸起、溢泪、异物感。分泌物送检培养结果显示，34 例中共有20例真菌生长，6例细菌生长，检出率分别为59%、 18%，其余8例未检出。10例泪小管结石经病理检查共发现曲霉菌3例，念珠菌5例，放线菌2例，在Gram染色显微镜下有4例发现放线菌丝体。泪小管炎误诊为其他眼部疾病，其中慢性泪囊炎12例、慢性结膜炎8例、急性结膜炎6例、睑腺炎4例，误诊率达到了88%。

结论：泪小管炎多发于中老年人群中，女性多于男性，且多见下泪小管病变。引发泪小管炎的主要致病菌可能是真菌，临床治疗可辅以抗真菌类药物。对于泪小管结石的清除工作，应区分致病菌的种类进行针对性治疗。对于误诊情况，要从泪小管炎与其他眼部疾病不同的临床表现入手，仔细检查，谨慎处理。

AIM:To analyze the 34 cases of patients with diagnosis of lacrimal duct disease, to explore the cause and clinical characteristics of lacrimal duct inflammation, and to study the common misdiagnosis to improve the diagnosis rate, to provide clinical experience for medical workers.

METHODS:A total of 34 eyes of 34 patients were selected from 2011-06 to 2015-06 to our hospital for lacrimal duct incision. Clinical data of patients including age and gender distribution, eye and lesion location, duration, canaliculitis clinical symptoms and previous misdiagnosis were collected. The operation of lacrimal duct was carried out, and the secretion of lacrimal secretion was checked.

RESULTS:Patients over the age of 40 accounted for 77% of the population, men accounted for 23.5%, women accounted for 76.5%. Left eye in 15 cases, right eye in 19 cases, and were monocular onset, 26 cases(76%)of patients with lower lacrimal duct inflammation. Clinical symptoms:increased secretion, canthal conjunctival congestion, swelling, lesion location around the lacrimal puncta swelling and tenderness, slightly raised, epiphora, foreign body sensation. The culture results Showed 34 cases of discharge inspection. A total of 20 cases were fungal growth, 6 cases of bacterial growth rate were 59%, 18%, and 8 cases were not detected, 10 cases of lacrimal duct stone were found by pathological examination. There were 3 cases of Aspergillus, 5 cases of Candida, 2 cases of actinomycetes, 4 cases found in Gram staining microscope. Misdiagnosis of canaliculitis for other eye diseases, including 12 cases of chronic dacryocystitis, 8 cases of chronic conjunctivitis, 6 cases of acute conjunctivitis, stye in 4 cases, the misdiagnosis rate reached 88%.

CONCLUSION:In the middle and old aged people, the lacrimal duct is more than that of the male. The main pathogenic bacteria causing lacrimal duct infection may be fungi, which can be treated with anti-fungal drugs. For the removal of the lacrimal duct stone, we should distinguish the types of pathogenic bacteria for the treatment of the disease. In the case of misdiagnosis, the clinical manifestations of different clinical manifestations from the lacrimal duct infection and other diseases of the eye should be carefully examined and carefully treated.

广东省医学科研基金(No.A2015041); 中山市第一批科技计划项目(No.2015B1007)